The Relationships Between Adverse Childhood Experiences, Patient-Centered Communication, and Care-Seeking Intention

Adverse childhood experiences (ACEs) are linked to distinct care-seeking patterns; however, the interpersonal pathways underlying care engagement remain underspecified. We tested whether patient-centered communication (PCC) mediates associations between ACEs and intentions to seek general- and women's care among 577 U.S. women who completed a general checkup or wellness visit within the past 12 months. ACEs, PCC, and intentions of general or women's care-seeking were measured using the Philadelphia ACEs Survey, patient-reported items outlined in the Patient-Centered Communication in the Cancer Care framework, and one-item questions on how likely they are to schedule a general or OB/GYN checkup in the next 12 months, respectively. Higher ACEs exposure was significantly associated with lower perceived PCC (r = -.21, p < .01), but not directly with lower intention to seek future care. Perceived PCC was positively associated with intentions to seek general (r = .13, p < .01) and women's care (r = .10, p < .05), and PCC mediated the association between ACEs and intentions to seek general (indirect effect β = -.03, p = .03) and women's (β = -.02, p = .02) care. Findings identify PCC as a modifiable communication pathway through which ACEs may influence future engagement with care.